Patient Case Studies

Anterior Cervical Discectomy and Fusion

Here is a patient with a prolonged history of neck pain with arm pain and numbness. She underwent a cervical fusion in the form of an Anterior Cervical Discectomy and Fusion. This was performed by Dr. Pablo Pazmino with a new device (seen below), which does not require a metal plate.

“It was important to me to have surgery that was minimally invasive, because I’ve been a dancer and I move all the time and I was frightened to have anything else. As it turned out, surgery was like a miracle. A few days later I was ready to go, with my neck surgery. With my spine surgery (her lumbar decompression performed one year ago) which took a little bit longer was actually very very successful. I could do things that I wasn’t able to do before. I had lost connection with. Particularly I can feel it when I do my Yoga class and the difference is amazing. It has been a very successful experience for me and I would recommend it to anybody”

With this new technology, offered by Dr. Pazmino at Spinecal, this Nuvasive Interlock cage can be placed into a degenerated segment of the neck to restore disc height and alignment. In fact if you notice her radiographs multiple levels were degenerated, but only the two most degenerated levels needed to be addressed. This patient is now one week out from her surgery performed by Dr. Pazmino at Cedars Sinai Medical Center, and as you can tell from her testimonial she has already noticed complete relief of her neck and arm pain.

As it turns out doing more levels would have been completely unnecessary. Dr Pablo Pazmino feels often “doing less is more,” meaning that only doing the levels that need to be done is often all that is necessary. So in this case even though it was a fusion (which was required) Dr. Pazmino was able to perform the procedure in a minimally invasive manner sparing other levels from surgery.

These are her Xrays of her neck taken after her surgery. These Xrays show that her new disc spacers are in place and have restored the natural curvature in her neck.

X-Rays After Surgery

In certain situations, patients with disc herniations need the entire disc and fragments removed to relieve pressure on the spinal cord and nearby nerves. Once the disc has been removed something needs to be put in its place.

These Nuvasvie brand spacers are an option and can be seen here. They are made of substance called PEEK (Poly Ether Ether Ketone) which feels like plastic. This material has properties which closely resemble our native bone. Dr. Pazmino places screws through the cages into the bone to hold them securely in position. Because these cages are made out of PEEK they are see through on Xrays and this allows Dr. Pazmino to closely follow the healing process which occurs inside the cages.

Bone is placed inside the cages to stimulate healing. There are several choices and material Dr. Pazmino can offer you to fill this cage. We can use local bone, transplanted bone from your hip or bone taken from a cadaver. This bone starts to heal within the cage and joins, or fuses, the bones above and below the spacer to each other. This process takes a year to complete. In three months this cage is filled with bone which is the consistency of cotton candy, in 6 months this bone is the consistency of Styrofoam, and by 12 months this bone inside the cage is strong like oak and normal bone. By 12 months the fusion process can be considered complete. In the meantime the screws through the cage keep the spacer in place. This is why Dr. Pazmino follows his patients at 3 weeks, 6 weeks, 3 months, 6 months and one year.